Collangenous Colitis vs. Microscopic Colitis???
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Collangenous Colitis vs. Microscopic Colitis???
Confused.....I was diagnosed with Collangenous Colitis in 1997. The medical field tends to use CC and MC interchangeably. Can someone explain the physiological differences between the two, and, does treatment and diet differ for each? THX! Carol
Hi Carol,
The treatment and the clinical symptoms are the same. There are at least a dozen different specific types of this syndrome that have been named and described so far, but most GI docs are only familiar with the two most common forms, LC and CC. Though all of these different types have specific laboratory (diagnostic) markers, they can all be referred to as MC (since they all have the same clinical symptoms and the same treatment).
The basic difference between CC and LC is that CC involves thickened collagen bands (greater than 10 microns) in the lamina propria of the epithelia of the colon. LC is marked by the infiltration of above normal numbers of lymphocytes (more than 20 lymphocytes per 100 enterocytes), but normal collagen band thickness. CC may or may not present with an elevated lymphocyte count. Of course, examination under a microscope of slides made from biopsy samples taken from the colon is necessary in order to determine any of these diagnostic criteria. The lymphocytes involved are known as T cells.
You're most welcome,
Tex
The treatment and the clinical symptoms are the same. There are at least a dozen different specific types of this syndrome that have been named and described so far, but most GI docs are only familiar with the two most common forms, LC and CC. Though all of these different types have specific laboratory (diagnostic) markers, they can all be referred to as MC (since they all have the same clinical symptoms and the same treatment).
The basic difference between CC and LC is that CC involves thickened collagen bands (greater than 10 microns) in the lamina propria of the epithelia of the colon. LC is marked by the infiltration of above normal numbers of lymphocytes (more than 20 lymphocytes per 100 enterocytes), but normal collagen band thickness. CC may or may not present with an elevated lymphocyte count. Of course, examination under a microscope of slides made from biopsy samples taken from the colon is necessary in order to determine any of these diagnostic criteria. The lymphocytes involved are known as T cells.
You're most welcome,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hi Al.
Yes, the T cells that infiltratrate the epithelia of the intestinal mucosa are CD8+ lymphocytes and those found in the lamina propria are CD4+ lymphocytes. It is thought that CD4+ T cells mediate the pathogenic process in celiac disease. Believe it or not (I verify this with citations in my book), the histology is virtually identical in both the small intestine and the colon, for both celiac disease and MC. Therefore, it's pretty safe to assume that what applies to one syndrome also applies to the other, as far as inflammatory modulators are concerned.
You're most welcome,
Tex
Yes, the T cells that infiltratrate the epithelia of the intestinal mucosa are CD8+ lymphocytes and those found in the lamina propria are CD4+ lymphocytes. It is thought that CD4+ T cells mediate the pathogenic process in celiac disease. Believe it or not (I verify this with citations in my book), the histology is virtually identical in both the small intestine and the colon, for both celiac disease and MC. Therefore, it's pretty safe to assume that what applies to one syndrome also applies to the other, as far as inflammatory modulators are concerned.
You're most welcome,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
THX Tex for a great explanation! Another thought.....does the thickening of the collengen layer come and go which might explain periods of relief from the condition? And, is it the D that ends up creating scar tissue in he lining of the colon? I ended up with a bowel obstruction 1 1/2 years ago which required surgery and my GI said that it could happen again. Sorry to be a pest.....Carol
Carol,
Yes, case studies show that the disease can segue from CC to LC, or vice versa, which implies that both lymphocyte infiltration and collagen band thickness can wax and wane over time.
IMO, the inflammation is the cause of bowel dysplasia (abnormal tissue growth or abnormal development). Bowel stenoses/obstructions are not nearly as common with MC as they are with the other inflammatory bowel diseases, but I suspect that there may be a connection, especially for patients who have diverticulitis issues. Almost 7 years ago, I had to have a stenosis surgically removed from my sigmoid colon, after it caused an obstruction. I suspect that I had a somewhat rare condition known as diverticular colitis, which causes a stenosis to form in the colon in about 25% of cases. Most GI docs seem to be unaware of the condition, but interestingly, according to research, the inflammation associated with diverticulitis is the same type associated with MC, namely lymphocytic infiltration with T cells.
Never hesitate to ask questions -- we all learn from these discussions.
Tex
Yes, case studies show that the disease can segue from CC to LC, or vice versa, which implies that both lymphocyte infiltration and collagen band thickness can wax and wane over time.
IMO, the inflammation is the cause of bowel dysplasia (abnormal tissue growth or abnormal development). Bowel stenoses/obstructions are not nearly as common with MC as they are with the other inflammatory bowel diseases, but I suspect that there may be a connection, especially for patients who have diverticulitis issues. Almost 7 years ago, I had to have a stenosis surgically removed from my sigmoid colon, after it caused an obstruction. I suspect that I had a somewhat rare condition known as diverticular colitis, which causes a stenosis to form in the colon in about 25% of cases. Most GI docs seem to be unaware of the condition, but interestingly, according to research, the inflammation associated with diverticulitis is the same type associated with MC, namely lymphocytic infiltration with T cells.
Never hesitate to ask questions -- we all learn from these discussions.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hi Al,Al wrote:Are you getting the book ready for e-readers?
As soon as I complete the process to make it available in print, I plan to see what's needed to convert it to digital format for e-readers. As far as I'm aware, it mostly requires a simple conversion process, which can be done by computer. To do it right, though, the font may have to be changed, to make it easier to read on a monitor or other digital screen, and whenever the font is changed, it becomes necessary to edit the entire text, in order to eliminate orphan lines, etc., and obtain neat page formatting. Anyway, I'll postpone that until after I get it it published in printed form. I still have to do the cover design, and hopefully, after a final check of the complete file, it will be ready to upload and order a proof.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hmm. Sounds like another poll could be enlightening. One possible problem is that younger people usually don't get diverticulosis, but by age 65, most people in the Western world have it.Tex wrote:according to research, the inflammation associated with diverticulitis is the same type associated with MC, namely lymphocytic infiltration with T cells.
Gloria
You never know what you can do until you have to do it.